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General NPI Number Information
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NPI Number | 1528110947
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Entity Type | Individual
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Provider Name | JORDAN C ISERMAN MD
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Gender | Male
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 01/30/2017
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Provider Practice Location Address
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Address Line | 900 GARDEN GATE CIR
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City | PENSACOLA
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State | FL
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Zip | 32504-8629
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Country | US
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Telephone | 850-478-0008
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Fax | 850-494-1817
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Provider Business Mailing Address
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Address Line | 900 GARDEN GATE CIRCLE
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City | PENSACOLA
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State | FL
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Zip | 32504-8629
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Country | US
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Telephone | 850-478-0008
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Fax | 850-494-1817
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | ME61308
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License Number State | FL
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